Carotid Angioplasty and Stenting vs Carotid Endarterectomy for Treatment of Asymptomatic Disease

Tang, Gale L.; Matsumura, Jon S.; Morasch, Mark D.; Pearce, William H.; Nguyen, Antoinette; Amaranto, Daniel; Eskandari, Mark K.

doi:10.1001/archsurg.143.7.653

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…The study cohorts ranged from 65 to 6940 patients. All articles presented the results of observational, retrospective, comparative studies [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. The studies' characteristics are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Data on asymptomatic patients were available from nine studies (2850 patients; 1707 CEA, 1143 CAS) [11][12][13][14][15]20,[22][23][24]. In asymptomatic patients undergoing CEA the pooled incidence of neurological event, MI and death was 1% (95% CI 0-2%), 0% (95% CI 0-1%) and 0% (95% CI 0-1%), respectively.…”

Section: Asymptomatic Patientsmentioning

confidence: 99%

“…Differences in neurological events between the CEA and CAS groups in asymptomatic patients[11][12][13][14][15]20,[22][23][24].…”

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confidence: 99%

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Early Outcomes of Carotid Revascularization in Retrospective Case Series

Nana

Kouvelos

Brotis

et al. 2021

JCM

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Background: Most data in carotid stenosis treatment arise from randomized control trials (RCTs) and cohort studies. The aim of this meta-analysis was to compare 30-day outcomes in real-world practice from centers providing both modalities. Methods: A data search of the English literature was conducted, using PubMed, EMBASE and CENTRAL databases, until December 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA) guidelines. Only studies reporting on 30-day outcomes from centers, where both techniques were performed, were eligible for this analysis. Results: In total, 15 articles were included (16,043 patients). Of the patients, 68.1% were asymptomatic. Carotid artery stenting (CAS) did not differ from carotid endarterectomy (CEA) in terms of stroke (odds ratio (OR) 0.98; 0.77–1.25; I2 = 0%), myocardial ischemic events (OR 1.03; 0.72–1.48; I2 = 0%) and all events (OR 1.0; 0.82–1.21; I2 = 0%). Pooled stroke incidence in asymptomatic patients was 1% (95% CI: 0–2%) for CEA and 1% for CAS (95% CI: 0–2%). Pooled stroke rate in symptomatic patients was 3% (95% CI: 1–4%) for CEA and 3% (95% CI: 1–4%) for CAS. The two techniques did not differ in either outcome both in asymptomatic and symptomatic patients. Conclusion: Carotid revascularization, performed in centers providing both CAS and CEA, is safe and effective. Both techniques did not differ in terms of post-procedural neurological and cardiac events, both in asymptomatic and symptomatic patients. These findings reiterate the importance of a tailored therapeutic strategy and that “real-world” outcomes may only be valid from centers providing both treatments.

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